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Do I need a tummy tuck or could I just do certain workouts to fix my Diastases Recti?

Q:

I still have a large gap in my stomach muscles 14 months postpartum from my third child. I really don't want to have surgery but can still see a gap when I lift my head off the ground while lying on my back. Do I need a tummy tuck or could I just do certain workouts to fix my Diastases Recti? I am still nursing my littlest and plan to continue until she is 2, could I still breastfeed after having a tummy tuck?

A:

In general, exercise does not correct a diastasis of the rectus muscles because there is no muscle that pulls them together horizontally. That is one of the primary reasons for doing tummy tucks, and if it could be fixed with exercise we would send our patients to the gym rather than taking them to the operating room. You should not do it while you are breastfeeding however, so best to wait.

Richard A. Baxter, M.D.
Mountlake Terrace, WA

A:

Unfortunately surgery is required to repair a diastasis. Typically a full tummy tuck incision is necessary. I would wait a few months after you are no longer breast feeding to have the procedure. The procedure will not cause problems with breast feeding in the future.

A:

Unfortunately, I am not aware of surgeons that believe diastasis recti can be fixed by exercise or other non-surgical technique, but tummy tuck (abdominoplasty) does that really well.  In the ideal abdomen, the left and right rectus abdominus muscles are separated by a narrow line of strong fibrous tissue, the linea alba.  Weight fluctuations including pregnancy can stretch this, making it wider and weaker.  It is not necessarily a hernia, but can cause bulging or the gap you describe.  Strengthening the adjacent muscles wouldn't make them become closed together, although this should help your overall abdominal tone and contour.

Your future plastic surgeon could use sutures to bring those muscles back closer together and reduce the slack caused by pregnancies.  This is one of the components of tummy tuck.  Skin and fat removal are the others, and should be adapted to your needs.

Tummy tuck would not interfere with future breast feeding.  However, it is often best to defer the surgery until after your child has finished breast feeding, and is a little older.  This will make your early recovery process easier.

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